Teletherapy is mental health counseling over the phone or online.
Teletherapy can be convenient for both the client and the therapist. Most research suggests that it works just as well as in-person counseling.
Teletherapy is any remote therapy that uses technology to help the therapist and client communicate. Some examples of teletherapy include:
- doing therapy sessions over the phone
- having a group chat for group therapy
- using videoconferencing for individual, couples, or group therapy
- receiving therapy via email or instant messenger
- using apps that connect clients to therapists and offer therapy within the app
Teletherapy provides a range of benefits in comparison with traditional therapy.
For therapy clients
- Greater access to care: Some people are unable to use traditional therapy due to physical disabilities, geographic location, or scheduling issues.
- Lower costs: Teletherapy may help clients save money on treatment. Clients are also likely to incur fewer therapy-associated expenses when they do not have to travel to receive treatment or pay for child care.
- High satisfaction: Users of quality teletherapy report high satisfaction with treatment.
- More privacy: People who choose teletherapy do not have to sit in busy waiting rooms but can seek treatment in the privacy of their own homes. For some, this alleviates privacy concerns.
- Better public health: The COVID-19 health crisis demonstrates that the ability to seek medical care at home can slow the spread of illness and protect vulnerable populations. Teletherapy allows people to get mental health treatment at home without risking the spread of infection during epidemics and pandemics.
Some therapists may find that teletherapy suits their personal style and allows them to meet their practice goals. Some benefits include:
- Reduced overheads: Maintaining an office can be expensive. Therapists who switch to a telehealth-only model can eliminate many of their overheads. Those who offer part-time teletherapy may be able to rent office space on just a few days of the week, lowering costs.
- The ability to reach more clients: Telehealth may improve access to therapy for people with disabilities, financial worries, transportation difficulties, and other barriers. This improved access enables therapists to help more people. Widening their potential consumer base can help therapists earn more money.
- A shorter commute: A therapist who exclusively offers teletherapy may be able to support clients from home, reducing or eliminating their commute.
While teletherapy has many benefits, there are also some possible limitations.
For therapy clients
Teletherapy is not for everyone. Some drawbacks include:
- Compliance: The Health Insurance Portability and Accountability Act (HIPAA) requires healthcare providers, including therapists, to protect patient or client privacy. Unsecure chat and other programs may expose sensitive data, so clients should work only with therapists who encrypt data.
- Therapy environment: For people with little privacy at home, finding the time and space for therapy can be stressful. Treatment in the office may offer a low stress alternative to treatment at home.
- Technical difficulties: Slow internet connections, glitches in video software, and communication delays can make online therapy feel more stressful and less personal. For people who lack technological proficiency or do not trust digital platforms, telehealth may not be a good option.
- Communication: Communicating across a digital channel can make it more difficult to read body language and other subtle cues. Email and phone therapy eliminate these forms of communication.
Some challenges that therapists may face with digital therapy include:
- Ethical and legal issues: Therapists must comply with state licensing board regulations in both the state where they practice and the state where they treat a client. This compliance can require significant legal knowledge, and violating the law could endanger a therapist’s license.
- More client anonymity: When therapists meet with clients on a digital platform, it may be more difficult to support those who pose a danger to themselves or others. Clients may even be able to conceal their identities. Therapists have a duty to warn the proper authorities if a client is at risk of harming themselves or others, and client anonymity can make this more difficult, potentially interfering with the therapist’s ethical obligations.
- Client privacy: Therapists must comply with HIPAA and other privacy laws. Choosing the right platform and taking proactive steps to secure client data demands time and technical proficiency.
- Communication barriers: It can take longer to establish a strong rapport with clients over digital networks. Some therapists may struggle to read body language and other subtle forms of communication, making it more difficult to offer high quality treatment.
Teletherapy is similar to traditional therapy. In-person therapy does not require physical contact or laboratory tests, so it is possible to replicate most of the therapy experience virtually, especially with video chat. Teletherapy can, therefore, help with a wide range of conditions and issues, including depression, anxiety, relationship problems, trauma, and chronic stress.
Emerging research suggests that teletherapy can treat most issues for which scientists have tested it. For example, a 2010 analysis suggests that distance-based cognitive behavioral therapy (CBT) for depression may be just as effective as in-person treatment.
People considering teletherapy should ask their healthcare provider about their approach.
While it is possible to do teletherapy via email or phone, contemporary telemental health sessions typically use video chat.
The therapeutic process is similar to in-person therapy. It usually begins with a few initial sessions during which the therapist and client get to know one another and discuss treatment goals. After that, the therapist may dig more deeply into the client’s issues, make recommendations for behavioral changes, and encourage the client to reflect on their emotions.
The therapist may ask the client to take steps to ensure confidentiality. These might include:
- logging on from a private network
- keeping their computer locked to prevent others from viewing the session
- accessing therapy via an encrypted therapy platform
Clients should also ask their therapists what specific steps they take to protect client confidentiality and prevent third parties from viewing sessions or session notes.
Although anyone can offer to support another person online or over the phone, only licensed professionals can describe their services as therapy. Clinicians can call themselves therapists, depending on the state in which they work.
Some examples of professionals who may provide teletherapy include:
- licensed professional counselors
- licensed marriage and family therapists
- licensed clinical social workers
- licensed psychologists
- licensed psychiatrists
State licensing rules vary, but a therapist must generally hold a license in the state where they treat the client. This rule means that a clinician who holds a license in Tennessee may not be legally allowed to treat a client who lives in California. Providers should check with the licensing board in the client’s home state to identify their ethical and legal duties.
Teletherapy is an ideal option for people who find it difficult to access therapy in person. It is also an excellent option for slowing the spread of illness, for example, during the COVID-19 pandemic or in the flu and cold season.
As with other health services, quality treatment gets better results. A person should work with their therapist to devise an effective course of treatment that offers the most benefits.